• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Shared decision making intervention linked to improved value/treatment choice concordance in LVAD destination therapy

byJames EnglandandAnees Daud
March 6, 2018
in Cardiology, Emergency, Imaging and Intervention, Public Health, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. In this randomized, stepped-wedge control trial of patients with heart failure under consideration for mechanical circulatory support (MCS), a shared decision-making educational intervention was linked with improved patient comprehension of left ventricular assist devices (LVAD) and concordance of treatment choice with patient values.

2. The shared decision making intervention did not significantly alter the concordance between patient values and the final therapy pursued.

Evidence Rating Level: 2 (Good)

Study Rundown: Patients with high-mortality medical conditions are often presented with different choices for therapy. Decision making reflects patient values, understanding of the underlying condition, and perceived risks and benefits of the available interventions. In patients with severe heart failure who are not transplant candidates, destination therapy with LVAD may prolong life, but also involves alterations in caregiver needs, lifestyle, and intervention-related complications. Patient education on LVAD destination therapy is limited by poor communication by the clinician, and biased industry provided literature on available devices. The current study sought to evaluate the impact of an education and literature-based decision aid program on patient comprehension and concordance with pre-existing values. The study found that the intervention improved patient knowledge, and concordance between values and patient choice of therapy. However, concordance of patient values and final therapy received at 6 months did not significantly change following the therapy.

The main strengths of this study included the evaluation of all patients initially considered for LVAD destination therapy, rather than only those who received the devices. The main limitations of the study included low rate of follow-up in those who declined LVAD therapy, a predominantly white and male population, and the difficulty in generalizing the results to those outside very specialized centers.

Click to read the study in JAMA Internal Medicine

Relevant Reading: Improving Decision Support Tools for LVAD Recipients via Computational Analyses of Online Support Group Discussions

RELATED REPORTS

Interatrial shunt device not effective in patients with symptomatic heart failure

Predicted long-term effects of dapagliflozin in heart failure suggest association with improved event-free survival

Hemodynamic-guided management of heart failure may reduce hospitalization rates

In-Depth [randomized controlled trial]: This study, the Multicenter Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure (DECIDE-LVAD), was a hospital-level randomized, stepped-wedge (phased roll-out) trial involved 6 MCS programs in the United States. During the 20-month enrollment period, clinician-patient dyads were included if they were 18-years or older with severe heart failure not a candidate for transplant and being considered for destination LVAD therapy. The intervention consisted of a 2.5-hour clinician training session on shared decision support, and the use of video and pamphlet decision aids for patients. The primary outcome of decision quality was assessed by evaluation of patient knowledge through a 10-item test, and concordance between patient value score and treatment choice.

The study found that for the 248 patients enrolled in the study, patient knowledge scores increased by 5.5% (p = 0.03). Patients in the control group favored LVAD more often (47 [59.5%] vs 95 [91.3%], p < 0.001), and concordance between patient values and treatment choice improved (difference in Kendall’s τ, 0.28; 95%CI, 0.05-0.45). There was no change in concordance for patient values and actual treatment received.

Image: PD

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: congestive heart failureLVAD
Previous Post

Balanced crystalloids decreases adverse kidney events compared to saline among critically ill patients: The SMART trial

Next Post

Hydrocortisone plus fludrocortisone decreases mortality in adults with septic shock

RelatedReports

30-Day mortality decreased in UK pediatric cardiac surgery from 2000-2010
Cardiology

Interatrial shunt device not effective in patients with symptomatic heart failure

March 29, 2022
Long-term outcomes for off-pump and on-pump CABG are similar
Cardiology

Predicted long-term effects of dapagliflozin in heart failure suggest association with improved event-free survival

November 8, 2021
Rilonacept may lower pericarditis recurrence in patients with relapsing pericarditis
Cardiology

Hemodynamic-guided management of heart failure may reduce hospitalization rates

September 22, 2021
Rilonacept may lower pericarditis recurrence in patients with relapsing pericarditis
Cardiology

Relative risk of heart failure from traditional risk factors is greater in younger than in older adults

April 23, 2021
Next Post

Hydrocortisone plus fludrocortisone decreases mortality in adults with septic shock

Wound surgical device found ineffective at infection control: ROSSINI Trial

2 Minute Medicine Rewind March 5, 2018

AAP recommends close monitoring of foster children by pediatricians

Physical, physiological benefits of hormonal treatment in gender dysphoria

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Metformin use may decrease risk of osteoarthritis development
  • Intensive blood pressure lowering by non-physician healthcare providers significantly reduces the risk of cardiovascular disease
  • Expectant management of patent ductus arteriosus noninferior to early ibuprofen use
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options